Bill Start

An act to add Section 1348.10 to the Health and Safety Code, relating to health.

LEGISLATIVE COUNSEL'S DIGEST

AB 1636, as amended, Monning.
Health and wellness programs.

Existing law provides for the licensure and regulation of health care service plans by the Department of Managed Health Care. Existing law provides for the regulation of health insurers by the Department of Insurance. The California Health Benefit Exchange is established in state government to facilitate enrollment of qualified individuals in qualified health plans. The State Department of Public Health is authorized to perform specified activities relating to the protection, preservation, and advancement of public health.

This bill would require the Department of Managed Health Care, in collaboration with the Department of Insurance, the California Health Benefit Exchange, and the State Department of Public Health, to convene a special committee consisting of specified members to review and evaluate health and wellness incentive and rewards
programs offered by health care service plans, health insurers, and employers. The bill would require the committee to evaluate these programs for effectiveness based upon scientific evidence and to examine the extent to which these programs may result in specified discrimination and would require the committee to discuss its findings in a final report submitted to the Assembly and Senate Committees on Health by March 30, 2014, as specified. The bill would require the committee to meet publicly and would require the first meeting to be conducted no later than March 30, 2013.

Digest Key

Vote:
MAJORITY
Appropriation:
NO
Fiscal Committee:
YES
Local Program:
NO

Bill Text

The people of the State of California do enact as follows:

SECTION 1.

Section 1348.10 is added to the Health and Safety Code, to read:

1348.10.

(a) The Department of Managed Health Care, in collaboration with the Department of Insurance, the California Health Benefit Exchange, and the State Department of Public Health, shall convene a special committee to review and evaluate health and wellness incentive and rewards programs offered by health care service plans, health insurers, and employers.

(b) The committee shall focus on the study of programs that provide incentives and rewards for enrollees, insureds, and employees to become more engaged in their health care and make choices that support health promotion and wellness, including worksite wellness programs and programs that offer or require health risk
appraisals, screening services, smoking cessation, health premium reductions, differential copayment or coinsurance amounts, and cash payments related to health promotion activities.

(c) The committee shall evaluate these programs for effectiveness based upon scientific evidence. The committee shall examine the extent to which these programs may result in discrimination based upon income, age, gender, race, ethnicity, medical condition, genetic information, claims experience, medical history, evidence of insurability, or any other health status-related factor.

(d) The committee shall meet publicly and engage experts and stakeholders in its deliberations. The first meeting of the special committee shall be conducted no later than March 30, 2013.

(e) Members of the committee shall include, but shall not be limited to, a bioethicist, a representative of the health care coverage industry, a chronic disease patient advocate, a physician and surgeon with expertise in managing patients with chronic conditions, a representative of consumers from low-income communities, a representative of consumers from communities of color, a health researcher with expertise in the impact of premium and cost-sharing on health care utilization, and an employer two employers
with experience in operating a nationally recognized worksite wellness program.

(f) The committee shall discuss its findings under this section in a final report submitted to the Assembly and Senate Committees on Health by March 30, 2014. This report shall also do both of the following: